Are waiting lists bad for your health?

Patients with serious illnesses have had their operations delayed in favour of less urgent cases so that hospitals can meet government waiting lists, according to an official report.

The National Audit Office found that doctors frequently treat patients not according to their clinical need, but to meet official targets.

The government has made waiting list targets a prominent feature of its healthcare reform strategy.

But this report suggests that by focusing on maximising the number of patients who are treated, the health service is being forced to abandon the principle that those in most serious need are given top priority.

Should the NHS have to meet targets laid down by politicians? Are they a good way of measuring the performance of the NHS? Or are they just bad for patients' health? How else can the system be monitored?

This Talking Point is now closed. Read a selection of your comments below.

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The answer is quite simple. Stop making weapons to kill people and bomb them from outer space. Stop the production of bio-chemical weapons and those stupid preparations for war. But, since people are basically unaware about this, why doesn't the 'press' come clean and tell the truth?
Dave Adams, USA

Patients are suffering due to the governments targets

Gwen, England

I don't think that the politicians should set targets for the NHS, some of the targets seem to be unrealistic combined with the amount of money allocated for health and the amount of doctors. I think the patients are suffering due to the governments targets and I think I better idea would be for each individual hospital to meet its own targets as the needs are different for each area and it can't be controlled by one uniform set of targets.
Gwen, England

Perhaps if we paid our Doctors and Nurses properly then they might remain in the NHS. An NHS Consultant is paid less than £40 for performing a hip replacement. The equivalent private operation might net him a thousand pounds. The NHS exists on slave labour wages. Many of the healthcare assistants, who do the most unpleasant and dirty jobs are paid a disgraceful pittance. Wake up, guys. If you want good healthcare I'm afraid you're going to have to pay for it.
Peter Logan, UK

Of course waiting lists are bad for everyone's health. The NHS is underfunded, understaffed and falling down around us. Give us the facilities we would like to be treated in, the best medics, that's the way. Trouble is few can actually afford to go private.
Hazel, UK

If the money isn't provided, the jobs cannot be done

Dr Liz Robinson, UK

It doesn't matter how much you monitor, measure, lecture, assess, test, cajole and blame. If the money isn't provided, the jobs cannot be done.
Dr Liz Robinson, UK

Too many men in suits are running the health service - badly I might add!
T Painter, England

Consultants are quick to respond to the waiting list initiatives because there's money at the end of the day. The doctor operating may not be the one to follow up the treatment. Under the initiative, the doctors simply operate and the post op care is someone else's headache. Where's the patient care in this equation?
Kamini, UK

The only people lauding the US-style health care are those whose companies pay a good part of the cost

Ian H, Brit in USA

In the USA, there are at least 40 million people who will wait forever for any care and twice as many more whose care package is totally worthless. The only people lauding the US-style health care are those whose companies pay a good part of the cost for them.
Ian H, Brit in USA

Tracey Dare cites South Africa and the US health 'services' as shining examples. Is this the South Africa where my aunt lives, where they still leave blacks to die by the road after a traffic accident if they haven't any medical insurance? And the US - yes, we can learn a lot from America, can't we? Like a two-tier health 'service' where the standard of service depends on your job title and status. Yes, our NHS does need an overhaul, but the only way it can benefit us all, is if we pay for it through taxes - and that would surely lose the Government the next election.
Anna, UK

I'm just glad the United States has privatised health care. I would much rather pay $40 a month and (soon) be able to sue if they screw up than have to wait in line and hope the system works properly.
Adam Ruddermann, Connecticut, USA

I think that it is about time we came to terms with the fact that humans are fallible

Andy, UK

I'm not suggesting we should deny people the quality of life they deserve but as a nation we appear to have become cosseted and spoiled to the extreme. I think that it is about time we came to terms with the fact that humans are fallible - we fall ill, we eventually die. It's no-one's fault yet we expect miracles of a system simply by the default that we have paid for it. Maybe we could stop expecting so much and we might see the purse strings less stretched.
Andy, UK

If doctors spent more time doing NHS work and less treating private patients then they may have something to complain about. Waiting list targets were introduced because doctors failed to treat NHS patients with the respect they deserve. For doctors to accuse ministers of causing the problem is a gross distortion of the truth and they know it!
Roger Ivan Hart, UK

Rob S is incredibly blinkered. NHS trust managers have always had a bad press but we also have a commitment to the NHS. If management is seen as a problem then it is simply that we have to meet the demands of the politicians. Many managers could attract higher salaries in the private sector but they also have as strong a commitment to provide high quality patient care as many of the "hands on" staff.
Rowell, UK

The waiting lists in the UK have got to be done away with

Gale, USA

I noticed that the majority of comments from Americans refer to our "wonderful" medical system. Have none of you tried to find a decent HMO doctor lately? We have different problems, but they are still critical. The waiting lists in the UK have got to be done away with. There should not be a quota to fill, or certain areas to target. Instead, it should be based on who is in the most need, and how that need can be filled quickly.
Gale, USA

A few years ago I had a plate inserted after I broken my leg. A year later I went back to have the plate removed. However I was informed that hospital practice had changed and they liked to leave them in for at least 2 years. I mentioned that I was covered by BUPA and the reply was "when do you want it taken out?" Had the period been increased to reduce the waiting list?
Caron, England

As an ex NHS manager I have first hand experience of the manipulation of waiting lists. Priorities were rarely based on actual clinical need rather than what was making headlines in the papers. If figures showed a particular department's waiting lists were increasing then an excuse would be found to discredit the figures, which would enable managers to extrapolate the figures from more favourable figures in the past. The answer to this problem is simple. Politicians should decide how much money is spent on the NHS and then leave decisions on where it is spent to the people who know where it is needed.
Matt Glenholme, UK

Management without leadership is manipulation, and the manipulation of figures hide problems affecting people

Peter Walker, UK

Management without leadership is manipulation, and the manipulation of figures hide problems affecting people. In that respect a 6-month wait for a bone scan was too late for my wife, even when it was reduced to a 4-month wait due to the kindness of the hospital staff at releasing information about a week where there were no appointments. She collapsed after 2 months, and her back pain was diagnosed as a compressed spine cause by multiple myeloma cancer. It was touch-and-go whether she would ever walk again, and she died twice during the operation. I am now unnecessarily a part-time carer of a disabled lady, I am very, very angry, and I want to see the leaders of the main political parties to ask them to justify this inhuman way of treating people.
Peter Walker, UK

No wonder affluent Brits come to the US when they have serious health issues. How barbaric and archaic is your system?
Paul, USA

Currently a lot of trained doctors and nurses go into private health or abroad after being trained at the TAX payers expense. To stop this drain, perhaps they should be forced to repay the training costs if they leave the NHS within 5 years of training?
Caron, England

The only reason why surgeons delay longer operation is because there is a waiting list initiative which pays surgeons more to reduce waiting lists. Rather than doing longer operations and therefore not reducing waiting lists as much. It is all a question of money.
Raj, England

Is this what the USA wants to adopt? Haven't your unworkable system prompted any our liberal friends to concede "public health is health at the lowest possible denominator"
Beata Lawson, USA

It's not the size of the waiting lists that should of concern it's only how long people wait that really matters.
Paul, UK

Waiting lists are irrelevant. They are just an ill thought out performance measure

Tony, USA

Waiting lists are irrelevant. They are just an ill thought out performance measure. What is relevant is the number of patients whose condition worsens or even die while on waiting for an operation. I am sure the majority of patient's conditions worsen while they are waiting. Such a scenario is unacceptable and the government has to find a way to eliminate it. If that means wholesale changes to the NHS and our traditional view of the healthcare system, then so be it. Any reform that saves more lives than the present system has to be an improvement!
Tony, USA

Being a GP, I receive a report from my local hospital monthly detailing the waiting times to see each consultant. I have the waiting times pinned up next to my desk. Most patients are horrified about the long waits to see a consultant. I ask them to write to their MSP to complain about the situation. Guess how many have actually done that? Only one. The fundamental problem I believe is the apathy of the people and their non-participation in the political system of the country.
John I, Scotland

Successive governments have decided not to put sufficient resources into health care. The result is that there are insufficient doctors, nurses and therapists and the state of NHS buildings and equipment are woefully lacking. This government has shot itself in the foot. They stuck to the (insufficient) spending plans of the previous administration for the first 3 years whilst stoking up public expectation, and doctor bashing for any failures. They are heading in the right direction by investing more in infrastructure and manpower, but it takes about 10 years to train a doctor or to build a new hospital. The NHS won't survive that long in its present state!
Dr Dennis Abadi, England

Thank God I am in America with no waiting list.
Richard T. Ketchum, USA

It's about time a report like this came out, and confirms my suspicion that the waiting list figures don't actually mean very much, even without the shameless manipulation that is done on them. Clearly something is wrong with a system where it looks better to have 1 million people waiting one year for a major operation than 10 million people waiting one week for a minor one.
Hugh, UK

No waiting lists in America. Ah, the benefits of socialised medicine.
Ron McElfresh, Alaska, USA

The saying 'there's so such thing as a free lunch' is so true

Anthea, UK

The saying 'there's so such thing as a free lunch' is so true - if we want a better health service, we need to pay for it via taxation.
The Tories were responsible for many of the problems faced by the NHS currently - chronic underfunding over 17 years. Why should a person's ability to pay for something dictate the level of care they receive?
Anthea, UK

Privatise the Health Service - adopt the same system as South Africa and US. Adopt private medical insurance (contributions made by your company as in a pension) and leave the NHS service to those living below the poverty line.
Tracey Dare, UK

The NHS is a political football. The Government of the time is keen to publish the good news (sometimes the same news two or three times) but when it increases costs without any funding they are very silent. Examples of this would include Working Time Regulations costs. Ward budgets were given money in the first year and Trusts have to find the money for future years. NICE drugs are never funded at the right level.
Rowell, UK

No doctor will push a cancer patient or a heart-attack patient to the back of the queue behind those waiting for relatively minor surgery

Graham Waters, UK

If a person has a life-threatening condition, they will be treated quickly. No doctor will push a cancer patient or a heart-attack patient to the back of the queue behind those waiting for relatively minor surgery.
Now we've got that out of the way, the question now is whether a patient with a fairly serious illness for a short time should be treated before a patient with a fairly minor illness which has been suffered for a considerable time. There will always be 'serious' illnesses. There will always be 'minor' illnesses. If we mandate that all 'serious' illnesses should be treated before 'minor' ones, then minor illnesses will never be treated. Does that sound fair to anyone?
Graham Waters, UK

Everyone who works in the NHS has known this for years, however, at the risk of sounding like I'm indoctrinated, through the NHS Plan the Government is changing the emphasis and looking at different ways of providing care e.g. services traditionally provided in hospitals to be provided by GPs and other primary healthcare professionals - trust me, things will get better!
Helen, Manchester, UK

Why don't the doctors ignore these waiting lists and treat people on a best needs basis. Oh, I've just realised - they won't get their money then! Tony Blair's pledge to get more doctors and nurses is hot air - it takes a long time to train a doctor in the NHS who then go and work in private clinics because it's more lucrative. For the past 20 years the NHS has been under-funded, under resourced and always under the political cosh! If I could afford private health care I'd take it.
Colin Dawson, UK

The Health Service is in a no-win situation

John, UK

The Health Service is in a no-win situation. It's cash strapped because we have historically voted for lower taxes instead of good public services. It's been accused of not providing enough information and forced to provide these statistics. Having done what its masters in government told it to do (reduce waiting lists) it's now pilloried because of the consequences of this strategy. It doesn't matter what you measure, or how you measure it. If there are insufficient doctors, nurses and beds to provide effective treatment for our increasingly elderly population, and insufficient funds to pay for increasingly expensive drugs and equipment, you will always have a health service that underperforms.
John, UK

Back in May this year I visited my GP re my prostrate problem. I have now received a letter from St Mary's Paddington saying that I have been given an appointment for 2nd November. That's 6 months just for that initial appointment. My point is, that at the time of my GP visit, I was responding to a national advertising campaign by the COI, showing commercials featuring some very famous actors, urging people like me, who are experiencing problems, to go along to their GP and get checked out. Why is the Minister responsible for such propaganda urging people to be checked out if the resources are not in place to do the checking in a reasonable period of time?
Brian Windus, UK

Waiting lists are obviously bad for patients' health. Whether one goes to the doctor for a minor or major ailment, he or she should be able to see the patient preferably the same day. Who is to take the blame if the condition of a patient with a minor ailment gets worse and the hapless person dies, simply because the doctor, a paid employee of the Government, had to delay seeing the case in favour of a serious patient? Justice ought to be done to all patients.
Albert Devakaram, India

Get rid of the overpaid so-called "managers" and give more control to the "hands-on" staff who are actually doing the work and deserve their salary!
Rob S, England

This is a very valid argument for privatising the health service.
Paul, Isle of Man

Some kind of points system might be devised

Malcolm McMahon, York, UK

Some kind of points system might be devised, but I'm not convinced you can improve on doctors' discretion. Better yet, let's get resources up to the point when all critical treatment can be done immediately with enough spare capacity to get people off the list for less critical stuff as fast as they get on it.
Malcolm McMahon, York, UK

Are those who were duped to 'Vote for schools and hospitals, vote Labour', pleased with themselves?
R. Nuttall, UK

Doctors should treat people purely on a clinical need basis. There should be NO political intervention. I'm sure Tony Blair would soon change things if one of his family was the person being pushed aside to make way for a man waiting for a reverse vasectomy and getting close to the 18 months limit!
Andy, UK

Perhaps it's time to kill the sacred cow of treatment being free at the point of delivery

Andy Millward, UK

If we want to sort the urgent/non-urgent debate, perhaps it's time to kill the sacred cow of treatment being free at the point of delivery. Several European countries charge a smallish fee at the point of delivery, but don't apparently have the same queue volumes as the UK. Perhaps this helps weed out hypochondriacs?
Andy Millward, UK

I agree with Julian Hayward. Britain spends about 7% of GDP on healthcare compared with 9-10% in places like Sweden. Politicians can talk about "reforming" the NHS as much as they want but ultimately if we want a world class healthcare system we have to pay for it. According to WHO the UK NHS is one of the most efficient healthcare systems in the world when you consider the level of care provided for the amount spent.
Mark, U.K.

I agree with Julian, but I won't be surprised if the Government uses this to start promoting private healthcare as an alternative to the NHS.
Tel, UK

The waiting list targets are causing problems, but the public has to realise those targets were created precisely because they complained about the opposite situation - minor operations being postponed over and over again to make room for more urgent cases. They have to wake up and accept - either urgent cases will be made to wait for minor ones, or minor ones will be put off indefinitely until all urgent cases are out of the way, or they will have to pay more tax to create more capacity in the NHS. You can't have your cake and eat it.
Julian Hayward, UK